Connecting BASHH National Audits to Local Audit and Practitioner Re-certification

1
Connecting BASHH National Audits to Local Audit
and Practitioner Re-certification

• Hugo McClean
• Secretary BASHH National Audit Group

2
Summary questions

• What do UK advisory bodies say about the role of
  audit in Quality?
• What do UK professional bodies say about the role
  of audit in re-certification?
• Can the BASHH national audits provide an
  important (local) resource?

will be posted on BASHH website
3
National advisory bodies

• the reinvigoration of clinical audit
• ..increase the impact that clinical audit has on
  healthcare quality

http//www.dh.gov.uk/ab/NCAAG/index.htm http//www
.hqip.org.uk/about-us/
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Healthcare Quality Improvement PartnershipNationa
l-Local Clinical Audit

• Seamless links between national and local audit
• Evidence of participation in audit, and the
  results of audit, used for secondary purposes.
  .revalidation of healthcare professionals

http//www.hqip.org.uk/local-clinical-audit/
5
UK Professional Bodies Royal College of
Nursing-

• Information and Knowledge 2 Information
  collection and analysis
• Core 4 Service improvement
• Core 5 Quality

http//www.dh.gov.uk/en/Publicationsandstatistics/
Publications/PublicationsPolicyAndGuidance/DH_4090
843
6
UK Professional Bodies Clinical audit
revalidation

• GMC
• Revised Framework / Explanatory Note to the
  Framework
• Derived from Good Medical Practice

• Royal College of Physicians
• Specialty-specific Framework

• BASHH
• In development

http//www.gmc-uk.org/doctors/licensing/revalidati
on/index.asp
http//www.rcplondon.ac.uk/clinical-standards/orga
nisation/Pages/Clinical-Audit.aspx
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GMC/Specialties Framework for appraisal and
assessment

• Domain 1 (Knowledge, Skills and Performance )
• Domain 2 (Safety and Quality )
• Participation in national or other multi-centre
  (e.g. regional) and local audit
• one full audit cycle within each five-year
  revalidation period
• with evidence of any practice change
  demonstrated by re-audit

http//www.gmc-uk.org/doctors/licensing/revalidati
on/gmp_framework.asp
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BASHH National Audits

• Annual online audits against BASHH clinical
  practice standards
• National and regional aggregates
• Comparisons between clinics in regions, between
  regions and against national average performance
• Regional Audit Chairs/Groups
• Embrace local audit

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National regional aggregates
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The Audit Cycle
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Using the BASHH National Audits- 1

• Managed the collection of data for my clinic for
  the BASHH 07 Audit on Management of Chlamydia
  Infection processed through clinical governance
• Produced a data set of performance measures for
  our clinic
• Compared our performance against other clinics in
  the Region, and against the BASHH national
  guideline for chlamydial management.
• only 40 of cases received written information
  about chlamydia
• 60 follow-up of cases in clinics

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Using the BASHH National Audits- 2

• Interventions
• changed from routine follow-up of cases in clinic
  to telephone follow-up
• led a process that found our health
  advisers/nurses dedicated time for telephone
  follow-up of chlamydial cases
• produced a new proforma in our clinic, including
  prompts for scheduling follow-up and providing
  written information

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Using the BASHH National Audits- 3

• Led re-audit of chlamydia management, using the
  same questions from the BASHH chlamydia audit
• Measured the effect of the interventions
  introduced aimed at improving practice and
  demonstrated significant improvement
• reduced follow-up in clinics from 60 to 20,
  freeing up time in clinics to see more patients
• increased our overall follow-up rate from 70
  to 85, by switching to telephone follow-up
• 60 of cases are now recorded as having
  received written information

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Development of BASHH national audits

• Moving towards shorter, higher impact audits and
  re-audits
• Based partly on new BASHH standards for STI
  services (in development)
• Linked to revalidation/recertification

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Summary

• BASHH national audits
• Embrace local audit
• Connect local audit to regional and national
  performance and national guidelines
• Provide individual clinicians with resource for
  re-certification performance review
• Completed audit cycles needed for physician
  relicensure specialist re-certification

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Acknowledgements

• Chris Carne, Chair BASHH National Audit Group
• Mark FitzGerald, BASHH